Origin of pain in migraine: evidence for peripheral sensitisation

@article{Olesen2009OriginOP,
  title={Origin of pain in migraine: evidence for peripheral sensitisation},
  author={Jes Olesen and Rami Burstein and Messoud Ashina and Peer Tfelt-Hansen},
  journal={The Lancet Neurology},
  year={2009},
  volume={8},
  pages={679-690}
}

Figures from this paper

The Lack of Peripheral Pathology in Migraine Headache

TLDR
It is suggested that a pathology, if one exists, may be in the brain and even that it may not be a pathology at all, and that Migraine headache might just happen because of random noise in an exquisitely sensitive and complex network.

The role of the neurovascular scalp structures in migraine

  • C. Cianchetti
  • Medicine
    Cephalalgia : an international journal of headache
  • 2012
TLDR
The data reported suggest a role for neurovascular scalp structures in at least some patients with migraine, and it would be of interest to find a clinical distinction between patients according to the prevalence of an intracranial or extracranial peripheral pain mechanism.

The jaw muscles and central sensitization in migraine

TLDR
The evidence for jaw muscle involvement in central sensitization in migraine has been investigated and it is demonstrated that stimulation of jaw muscle afferents excites neurons in the Vc and that nociceptor afferent impulses from muscles produce a long lastingcentral sensitization.

Migraine Pain and Nociceptor Activation—Where Do We Stand?

  • D. Levy
  • Biology, Psychology
    Headache
  • 2010
TLDR
The evidence leading to these disparate theories while siding with the primacy of nociceptor activation in the genesis migraine headache is reviewed, which further examines the potential future use of established human models of migraine for addressing the origin of migraine headache.

Pathophysiology of migraine and tension-type headache

TLDR
Sensitization of second-order neurons at the level of the spinal dorsal horn or trigeminal nucleus, sensitization of supraspinal neurons, and decreased descending inhibition from suPRaspinal structures play a major role in the pathophysiology of chronic tension-type headache.

Migraine as a state of brain dysfunction and neuronal hypersensitivity

TLDR
This work has shown that migraine is regarded as episodic or acute if it occurs less than 15 times per month, while chronic migraine is defined as more than 15 episodes per month continuing for more than 3 consecutive months.

Involvement of gap junction channels in the pathophysiology of migraine with aura

TLDR
Gap junction channels seem to be involved in several ways in the pathophysiology of migraine with aura and emerge as a new promising putative target in treatment of this disorder.

TRPS and Migraine

TLDR
The present review focuses on the potential role of the different TRP channels, especially TRPV1, in the migraine mechanism and the recent discovery of a variety of endogenous and exogenous TRP agonists known to induce migraine attack as well as their emerging role in neuropeptide release.
...

References

SHOWING 1-10 OF 168 REFERENCES

Sensitization of meningeal sensory neurons and the origin of headaches

TLDR
The activity of primary afferent neurons in the rat trigeminal ganglion that innervate the dural venous sinuses are recorded, showing properties of meningeal afferents that may contribute to the intracranial mechanical hypersensitivity that is characteristic of some types of clinically occurring headaches, and to the throbbing pain of migraine.

No relation between cephalic venous dilatation and pain in migraine

TLDR
The findings make it unlikely that the cephalic venous system is of major importance in migraine pain mechanisms and, therefore, less likely that neurogenic inflammation plays a significant part in humans during attacks of migraine without aura.

An association between migraine and cutaneous allodynia

TLDR
These findings suggest that the pathophysiology of migraine involves not only irritation of meningeal perivascular pain fibers but also a transient increase in the responsiveness of central pain neurons that process information arising from intracranial structures and skin.

Mast Cell Involvement in the Pathophysiology of Migraine Headache: A Hypothesis

Migraine attacks are triggered by a variety of conditions including endogenous and exogenous factors. Evidence suggests that activation and sensitization of primary afferent meningeal nociceptive

Extracranial blood flow, pain and tenderness in migraine. Clinical and experimental studies.

  • K. Jensen
  • Medicine, Psychology
    Acta neurologica Scandinavica. Supplementum
  • 1993
TLDR
Axonal reflexes between extracranial arteries and neighbouring myofascial tissues as well as referred pain mechanisms may account for the observed tenderness during migraine attacks.

The development of cutaneous allodynia during a migraine attack clinical evidence for the sequential recruitment of spinal and supraspinal nociceptive neurons in migraine.

TLDR
The way in which cutaneous allodynia develops by measuring the pain thresholds in the head and forearms bilaterally at several time points during a migraine attack in a 42-year-old male is studied and calls for early use of anti-migraine drugs that target peripheral nociceptors, before the development of central sensitization.

Response properties of dural nociceptors in relation to headache.

TLDR
The role of vasodilation in headache is called into question and the role of CGRP in headache may be through its action as a central neurotransmitter rather than through Vasodilation and activation of meningeal nociceptors.

Unitary hypothesis for multiple triggers of the pain and strain of migraine

TLDR
It is proposed that trigeminovascular projections from the medullary dorsal horn to selective areas in the midbrain, hypothalamus, amygdala, and basal forebrain are functionally positioned to produce migraine symptoms such as irritability, loss of appetite, fatigue, depression, or the quest for solitude.

EXPERIMENTAL STUDIES ON HEADACHE: PAIN-SENSITIVE STRUCTURES OF THE HEAD AND THEIR SIGNIFICANCE IN HEADACHE

TLDR
Data about the great variety of headaches resulting from distention of cranial arteries are specific, but there is evidence that the afferent fibers from the pain-sensitive cerebral arteries above the tentorium enter the brain stem primarily through the fifth cranial nerve.

Serotonin and Migraine

TLDR
Interestingly a promising new drug for the treatment of the acute attack, sumatriptan, has a very selective action as an agonist at a specific 5-HT1-like receptor sub-type, mediating vasoconstriction, which is localized on cranial blood vessels.
...